MARCH 19TH

POOR RICHARD'S ALMANACK

You may sometimes be much in the wrong, in owning your being in the right.

— Benjamin Franklin,1754

AMERICANREVOLUTION.ORG

DOMESTIC MEDICINE

CHAP. XLIII.

OF NERVOUS DISEASES.

OF all diseases incident to mankind, those
of the nervous kind are the most complicated and difficult to
cure. A volume would not be sufficient to point out their various
appearances. They imitate almost every disease; and are seldom
alike in two different persons, or even in the same person at
different times. Proteus-like, they are continually changingshape; and upon every fresh attack, the patient
thinks he feels symptoms which he never experienced before. Nor
do they only affect the body; the mind likewise suffers, and
is often thereby rendered extremely weak and peevish. The low
spirits, timorousness, melancholy, and fickleness of temper,
which generally attend nervous disorders, induce many to believe,
that they are entirely diseases of the mind; but this change
of temper is rather a consequence, than the cause of nervous
diseases.

CAUSES. - Every thing that tends to relax
or weaken the body, disposes it to nervous diseases, as indolence,
excessive venery, drinking too much tea, or other weak watery
liquors, frequent bleeding, purging, vomiting, &c. Whatever
hurts the digestion, or prevents the proper assimilation of the
food, has likewise this effect; as long fasting, excess in eating
or drinking; the use of windy, crude, or unwholesome aliments,
an unfavourable posture of the body, &c.

NERVOUS disorders often proceed from intense
application to study. Indeed few studious persons are entirely
free from them. Nor is this at all to be wondered at; intense
thinking not only preys upon the spirits, but prevents the person
from taking proper exercise, by which means the digestion is
impaired, the nourishment prevented, the solids relaxed, and
the whole mass of humours vitiated. Grief and disappointment
likewise produce the same effects. I have known more nervous
patients, who dated the commencement of their disorders from
the loss of a husband, a favourite child, or from some disappointment
in life, than from any other cause. In a word, whatever weakens
the body, or depresses the spirits, may occasion nervous disorders,
as unwholesome air, want of great fatigue, disagreeable apprehensions,
anxiety vexation, &c.

SYMPTOMS -We shall only mention some of the
most general symptoms of these disorders, as it would be both
an useless and an endless task to enumerate the whole. They generally
begin with windy inflations or distentions of the stornach and
intestines, the appetite and digestion are usually bad; yet sometirnes
there is an uncommon craving for food, and a quick digestion.
The food often turns sour on the stomach; and the patient is
troubled with vomiting of clear water, tough phleghm, or a blackish
coloured liquor resembling the grounds of coffee. Excruciating
pains are often felt about the navel, attended with a rumbling
or murmuring noise in the bowels. The body is sometimes loose,
but more commonly bound, which occasions a retention of wind
and great uneasiness.

THE urine is sometimes in small quantity,
at other times very copious and quite clear. There is a great
straitness of the breast, with difficulty of breathing; violent
palpitations of the heart; suddden flushings of heat in various
parts of the body; at other times a sense of cold, as if water
were poured on them; flying pains in the arms and limbs; pains
in the back and belly, resembling those occasioned by gravel;
the pulse very variable, sometimes uncommonly slow, and at other
times very quick; yawning, the hiccup, frequent sighing, and
a sense of suffocation, as if from a ball or lump in the throat;
alternate fits of crying and convulsive laughing; the sleep is
unsound and seldom seldom refreshing; and the patient is often
troubled with the night-mare.

AS the disease increases, the patient is molested
with head-achs, cramps, and fixed pains in various parts of the
body; the eyes are clouded, and often affected with pain and
dryness; there is a noise in the ears, and often a dulness of
hearing; in short, the whole animal functions are impaired. The
mind is disturbed on the most trivial occasions, and is hurried
into the most perverse commotions, inquietudes, terror, sadness,
anger, diffidence, &c. The patient is apt to entertain wild
imaginations and fancies; the memory becomes weak, and the judgment
fails.

NOTHING is more characteristic of this disease
than constant dread of death. This renders those unhappy persons
who labour under it peevish, fickle, impatient, and apt to run
from one physician to another; which is one reason why they
seldom reap any benefit from medicine, as they have not sufficient
resolution to persist in any one course till it has time to produce
its proper effects. They are likewise apt to imagine that they
labour under diseases from which they are quite free; and are
very angry if any one attempts to set them right, or laugh them
out of their ridiculous notions.

REGIMEN. - Persons afflicted with nervous
diseases ought never to fast long. Their food should be solid
and nourishing, but of easy digestion. Fat meats, and heavy sauces,
are hurtful. All excess should be carefully avoided. They ought
never to eat more at a time than they can easily digest; but
if they feel themseIves weak and faint between meals, they ought
to eat a bit of bread, and drink a glass of wine. Heavy suppers
are to be avoided. Though wine in excess enfeebles the body,
and impairs the faculties of the mind, yet taken in moderation,
it strengthens the stomach, and promotes digestion. Wine and
water is a very proper drink at meals: but if wine sours on the
stornach, or the patient is much troubled with wind, brandy and
water will answer better. Every thing that is windy or hard of
digestion must be avoided. All weak and warm liquors are hurtful,
as tea, coffee, punch, &c. People may find a ternporary
relief in the use of these, but they always increase the malady,
as they weaken the stomach and hurt digestion. Above all things,
drams are to be avoided. Whatever immediate ease the patient
may feel from the use of ardent spirits, they are sure to aggravate
the malady, and prove certain poisons at last. These cautions
are the more necessary, as most nervous people are peculiarly
fond of tea, and ardent spirits; to the use of which many of
them fall victims.

EXERCISE in nervous disorders is superior
to all medicines. Riding on horseback is generally esteemed the
best, as it gives motion to the whole body, without fatiguing
it. I have known some patients however, with whom walking agreed
better, and others who were most benefited by riding in a carriage.
Every one ought to use that which he finds most beneficial. Long
sea voyages have an excellent effect; and to those who can afford
to take them, and have sufficient resolution, we would by all
means recommend this course. Even change of place, and the sight
of new objects, by diverting the mind, have a great tendency
to remove these complaints. For this reason a long journey, or
a voyage, is of much more advantage than riding short journeys
near home.

A COOL dry air is proper, as it braces and
invigorates the whole body. Few things tend more to relax and
enervate than hot air, especially that which is rendered so by
great fires, or stoves in small apartments. But when the stomach
or bowels are weak, the body ought to be well guarded against
cold, especially in winter, by wearing a thin flannel waist-coat
next the skin. This will keep up an equal perspiration, and defend
the alimentary canal from many impressions to which it would
otherwise be subject, upon every sudden change from warm to cold
weather. Rubbing the body frequently with a flesh brush, or
a coarse linen cloth, is likewise beneficial, as it promotes
the circulation, perspiration, &c. Persons who have weak
nerves ought to rise early, and take exercise before breakfast,
as lying too long a-bed cannot fail to relax the solids. They
ought likewise to be diverted, and to be kept as easy and cheerful
as possible. There is not any thing which hurts the nervous system,
or weakens the digestive powers, more than fear, grief, or anxiety.

MEDICINES. - Though nervous diseases are seldom
radically cured, yet their symptoms may sometimes be alleviated,
and the patient's life rendered, at least, more comfortable,
by proper medicines.

WHEN the patient is costive, he ought to take
a little rhubarb, or some other mild purgative, and should never
suffer his body to be long bound. All strong and violent purgatives
are however to be avoided, as aloes, jalap, &c. I have generally
seen an infusion of senna and rhubarb in brandy answer very well.
This may be made of any strength, and taken in such quantity
as the patient finds necessary. When digestion is bad, or the
stomach relaxed and weak, the following infusion of Peruvian
bark and other bitters may be used with advantage.

TAKE of Peruvian bark an ounce, gentian root,
orange-peel, and coriander-seed, of each half an ounce; let these
ingredients be all bruised in a rnortar, and infused in a bottle
of brandy or whisky, for the space of five or six days. A table-spoonful
of the strained liquor may be taken in half a glass of water,
an hour before breakfast, dinner, and supper.

FEW things tend more to strengthen the nervous
system than cold bathing. This practice, if duly persisted in,
will produce very extraordinary effects; but when the liver or
other viscera are obstructed, or otherwise unsound, the
cold bath is improper. It is therefore to be used with very great
caution. The most proper seasons for it are summer and autumn.
It will be sufficient, especially for persons of a spare habit,
to go into the cold bath three or four times a-week. If the patient
be weakened by it, or feels chilly for a long time after coming
out, it is improper.

IN a patient affected with wind, I have always
observed the greatest benefit from the acid elixir of vitriol.
It may be taken in the quantity of fifteen, twenty, or thirty
drops, twice or thrice a-day in a glass of water. This both expels
wind, strengthens the stomach, and promotes digestion.

OPIATES are generally extolled in these maladies;
but as they only palliate the symptoms, and generally afterwards
increase the disease, we would advise people to be extremely
sparing in the use of them, lest habit render them at last absolutely
necessary.

IT would be an easy matter to enumerate many
medicines which have been extolled for relieving nervous disorders;
but whoever wishes for a thorough cure must expect it from regimen
alone; we shall therefore omit mentioning more medicines, and
again recommend the strictest attention to DIET, AIR, EXERCISE
and AMUSEMENTS.

OF MELANCHOLY.

MELANCHOLY is that state of alienation or
weakness of mind which renders people incapable of enjoying the
pleasures, or performing the duties of life. It is a degree of
insanity, and often terminates in absolute madness.

CAUSES. - It may proceed from a hereditary
disposition; intense thinking, especially where the mind is long
occupied about one object; violent passions or affections of
the mind, as love, fear, joy, grief, overweaning pride, and such
like. It may also be occasioned by excessive venery, narcotic
or stupefactive poisons; a sedentary life; solitude; the suppression
of custornary evacuations; acute fevers, or other diseases. Violent
anger will change melancholy into madness; and excessive cold,
especially of the lower extremities, Will force the blood into
the brain, and produce all the symptoms of madness. It may likewise
proceed from the use of aliment that is hard of digestion, or
which cannot be easily assimilated; from a callous state of the
integuments of the brain, or dryness of the brain itself. To
all which we may add gloomy or mistaken notions of religion.

SYMPTOMS. - When persons begin to be melancholy,
they are timorous; watchful; fond of solitude, fretful; fickle;
captious and inquisitive; solicitous about trifles; sometimes
niggardly, and at other times prodigal. The body is generally
bound; the urine thin, and in small quantity; the stomach and
bowels inflated with wind; the complexion pale; the pulse slow
and weak. The functions of the mind are also greatly perverted,
in so much that the patient often imagines himself dead, or changed
into some other animal. Some have imagined their bodies were
made of glass, or other brittle substances, and were afraid to
move, lest they should be broken to pieces. The unhappy patient,
in this case, unless carefully watched, is apt to put an end
to his own miserable life.

WHEN the disease is owing to an obstruction
of customary evacuations, or any bodily disorder, it is easier
cured than when it proceeds from affections of the mind, or an
hereditary taint. A discharge of blood from the nose, looseness,
scabby eruptions, the bleeding piles, or the menses, carry off
this disease.

REGIMEN - The diet should consist chiefly
of vegetables of a cooling and opening quality. Animal food,
especially salted or smoke-dried fish or flesh ought to be avoided.
All kinds of shell-fish are bad. Aliments prepared with onions,
garlic, or any thing that generates thick blood are likewise
improper. All kind of fruits that are wholesome may be eat with
advantage . Boerhaave gives an instance of a patient who, by
a long use of whey, water, and garden-fruit, recovered, after
having evacuated a great quantity of black-couloured matter.

STRONG liuors of every kind ought to be avoided as poison. The
most proper drink is water, whey, or very small beer. Tea and
coffee are improper. If honey agrees with the patient, it may
be eat freely, or his drink may be sweetened with it. Infusions
of balm-leaves, penny-royal, the roots of wild valerian, or the
flowers of the lime-tree may be drank freely, either by themselves,
or sweetened with honey, as the patient shall chuse.

THE patient ought to take as much exercise
in the open air as he can bear. This helps to dissolve the viscid
humours, it removes obstructions, promotes the perspiration,
and all the other secretions. Every kind of madness is attended
with a diminished perspiration; all means ought therefore to
be used to promote that necessary and salutary discharge. Nothing
can have a more direct tendency to increase the disease than
confining the patient to a close apartment. Were he forced to
ride, or walk a certain number of rniles every day, it would
tend greatly to alleviate his disorder; but it would have still
a better effect if he were obliged to labour a piece of ground.
By digging, hoeing, planting, sowing, &c. both the body and
mind would be exercised. A long journey, or a voyage, especially
towards a warmer climate, with agreeable companions, has often
very happy effects. A plan of this kind, with a strict attention
to diet, is a much more rational method of cure, than confining
the patient within doors and plying him with medicines.

MEDICINE. - In the cure of this disease particular
attention must be paid to the mind. When the patient is in a
low state, his mind ought to be soothed and diverted with a variety
of amusements, as entertaining stories, pastimes, music, &c.
This seems to have been the method of curing rnelancholy among
the Jews, as we learn from the story of King Saul; and indeed
it is a very rational one. Nothing can remove dieases of the
mind so effectually as applications to the mind itself, the most
efficacious of which is music. The patient's company ought likewise
to consult of such persons as are agreeabIe to him. People in
this state are apt to conceive unaccountable aversions against
particular
persons; and the very sight of such persons is sufficient to
distract their minds, and throw them into the utmost perturbation.

WHEN the patient is high, evacuations are
necessary. In this case he must be bled, and have his body kept
open by purging medicines, as manna, rhubarb, cream of tartar,
or the soluble tartar. l have seen the last have very happy effects.
It may be taken in the dose of half an ounce, dissolved in water-gruel,
every day, for sundry weeks, or even for months, if necessary.
More or less may be given according as it operates. Vomits have
likewise a good effect; but they must be pretty strong, otherwise
they will not operate.

WHATEVER increases the evacuation of urine
or promotes perspiration, has a tendency to rermove this disease.
Both these secretions may be promoted by the use of nitre and
vinegar. Half a drachm of purified nitre may be given three or
four times a-day in any manner that is most agreeable to the
patient; and an ounce and a half of distilled vinegar may be
daily mixed with his drink. Dr. Locker seems to think vinegar
the best medicine that can be given in this disease.

CAMPHIRE and musk have likewise been used
in this case with advantage. Ten or twelve grains of camphire
may be rubbed in a mortar with half a drachm of nitre, and taken
twice a-day, or oftener, if the stomach will bear it. If it will
not sit upon the stomach in this form, it may be made into pills
with gum asafoetida and Russian castor, and taken in the quantity
above directed. If musk is to be administered, a scruple or twenty-five
grains of it may be made into a bolus with a little honey or
common syrup, and taken twice or thrice a-day. We do not mean
that all these medicines should be administered at once; but
whichever of them is given, must be duly persisted in, and where
one fails another may be tried.

AS it is very difficult to induce patients
in this disease to take medicines, we shall mention a few outward
applications which sometimes do good; the principal of these
are issues, setons, and warm bathing. Issues may be made in any
part of the body, but they generally have the best effect near
the spine. The discharge from these may be greatly promoted
by dressing them with the mild blistering ointment, and keeping
what are commonly called the orrice pease in them. The most proper
place for a seton is between the shoulder blades; and it ought
to be upwards and downwards, or in the direction of the spine.

OF THE PALSY.

THE palsy is a loss or diminution of sense
or motion, or of both, in one or more parts of the body. Of all
the affections called nervous, this is the most suddenly fatal.
It is more or less dangerous, according to the importance of
the part affected. A palsy of the heart, lungs, or any part
necessary to life, is mortal. When it affects the stomach, the
intestines, or the bladder, it is highly dangerous. If the face
be affected, the case is bad, as it shews that the disease proceeds
from the brain. When the part affected feels cold, is insensible,
or wastes away, or when the judgment and memory begin to fail,
there is small hope of a cure.

CAUSES. - The immediate cause of palsy is
any thing that prevents the regular exertion of the nervous power
upon any particular rnuscle or part of the body. The occasional
and predisposing causes are various, as drunkness; wounds of
the brain, or spinal marrow; pressure upon the brain or nerves;
very cold or damp air; the supression of customary evacuations;
sudden fear; want of exercise; or whatever greatly relaxes the
system, as drinking much tea, or coffee, &c. Many people
imagine, that tea has no tendency to hurt the nerves, and that
drinking the same quantity of warm water would be equally pernicious.
This however seems to be a mistake. Many persons drink three
or four cups of warm milk and water daily, without feeling any
bad consequences; yet the same quantity of tea will make their
hands shake for twenty-four hours. That tea affects the nerves
is likewise evident from its preventing sleep, occasioning giddiness,
dimness of the sight, sickness, &c. The palsy may likewise
proceed from wounds of the nerves themselves, from the poisonous
fumes of metals or minerals, as mercury, lead, arsenic,

IN young persons of a full habit, the palsy
must be treated in the same manner as the sanguine apoplexy.
The patient must be bled, blistered, and have his body opened
by sharp clysters or purgative medicines. But, in old age, or
when the disease proceeds from relaxation or debility, which
is generally the case, a quite contrary course must be pursued.
The diet must be warm and invigorating, seasoned with spicy and
aromatic vegetables, as mustard, horse-radish, &c. The drink
may be generous wine, mustard, whey, or brandy and water. Friction
with the flesh brush, or a warm hand, is extremely proper, especially
on the parts affected. Blistering-plasters may likewise be applied
to the affected parts with advantage. When this cannot be done,
they may be rubbed with the volatile linement, or the nerve ointment
of the Edinbuirgh dispensatory. One of the best external applications
is electricity. The shocks should be received on the part affected;
and they ought daily to be repeated for several weeks.

VOMITS are very beneficial in this kind of
palsy, and ought frequently to be administered. Cephalic snuff,
or any thing that makes the patient sneeze, is likewise of
use. Some pretend to have found great benefit from rubbing the
parts affected with nettles; but this does not seem to be any
way preferable to blistering. If the tongue is affected, the
patient may gargle his mouth frequently with brandy and mustard,
or he may hold a bit of sugar in his mouth wet with the palsy-drops
or compound spirits of lavender. The wild valerian-root is a
very proper medicine in this case. It may either be taken in
an infusion with sage leaves, or half a drachm of it in powder
may be given in a glass of wine three times a-day. If the patient
cannot use the valerian, he may take of sal volatile oleosum,
compound spirits of lavender, and tincture of castor, each half
an ounce. Mix these together, and take forty or fifty drops
in a glass of wine, three or four times a-day. A table-spoonful
of mustard-seed taken frequently is a very good medicine. The
patient ought likewise to chew cinnamon-bark, ginger, or other
warm spiceries.

EXERCISE is of the utmost importance in the
palsy; but the patient must beware of a cold, damp, and moist
air. He ought to wear flannel next his skin; and, if possible,
should remove into a warmer climate.

OF THE EPILEPSY, OR FALLING SICKNESS.

THE epilepsy is a sudden deprivation of
all the senses, wherein the patient falls suddenly down, and
is effected with violent convulsive motions. Children, especially
those who are delicately brought up, are most subject to it.
It more frequently attacks men than women, and is very difficult
to cure. When the epilepsy attacks children, there is reason
to hope it may go off about the time of puberty. When it attacks
any person after twenty years of age, the cure is difficult;
but when after forty, a cure is hardly to be expected. If the
fit continues only for a short space, and returns seldom, there
is reason to hope; but if it continues long and returns frequently,
the prospect is bad. It is a very unfavourable symptom when the
patient is seized with the fits in his sleep.

CAUSES. - The epilepsy is sometimes hereditary.
It may likewise proceed from frights of the mother when with
child; from blows, bruises or wounds on the head; a collection
of water, blood, or serous humours in the brain; a polypus; tumours
or concretions within the skull; excessive drinking; intense
study; excess of venery; worms; teething; suppression of customary
evacuations; too great emptiness or repletion; violent passions
or affections of the mind, as fear, joy, &c. hysteric affections;
contagion received into the body, as the infection of the small-pox,
measles, &c.

SYMPTOMS - An epileptic fit is generally preceded
by unusual weariness; pain of the head,; dullness; giddiness;
noise in the ears; dimness of sight; palpitation of the heart;
disturbed sleep; difficult breathing; the bowels are inflated
with wind; the urine is in great quantity, but thin; the complexion
is pale; the extremities are cold, and the patient often feels,
as it were, a stream of cold air ascending towards his head.

IN the fit, the patient generally makes an
unusual noise; his thumbs are drawn in towards the palms of the
hands; his eyes are distorted; he starts, and foams at the mouth;
his extremities are bent or twisted various ways; he often discharges
his seed, urine, and faeces involuntarfly; and is quite destitute
of all sense and reason. After the fit is over, his senses gradually
return, and he complains of a kind of stupor, weariness, and
pain of his head; but has no remembrance of what happened to
him during the fit.

THE fits are sometimes excited by violent
affections of the mind, a debauch of liquor, excessive heat,
cold, or the like.

THIS disease, from the difficulty of investigating
its causes, and its strange symptoms, was formerly attributed
to the wrath of the gods, or the agency of evil spirits. In modern
times it has often, by the vulgar, been imputed to witchcraft
or fascination. It depends however as much upon natural causes
as any other malady; and its cure may often be effected by persisting
in the use of proper means.

REGIMEN. - Epileptic patients ought, if possible,
to breathe a pure and free air. Their diet should be light but
nourishing. They ought to drink nothing strong, to avoid swines
flesh, water-fowl, and likewise all windy and oily vegetables,
as cabbage, nuts, &c. They ought to keep themselves cheerful,
carefully guarding all violent passions, as anger fear, excessive
joy, and the like.

EXERCISE is likewise of great use; but the
patient must be careful to avoid all extremes either of heat
or cold, all dangerous situations, as standing upon precipices,
riding deep waters, and such like.

MEDICINE. - The intentions of cure must vary
according to the cause of the disease. If the patient be of a
sanguine temperament, and there be reason to fear an obstruction
in the brain, bleeding and other evacuations will be necessary.
When the disease is occassoned by the stoppage of customary evacuations,
these, if possible, must be restored; if this cannot be done,
others may be substituted in their place. Issues or setons, in
this case, have often a very good effect. When there is reason
to believe that the disease proceeds from worms, proper medicines
must be used to kill, or carry off these vermin. When the disease
proceeds from teething, the body should he kept open by emollient
clysters, the feet frequently bathed in warm water, and, if the
fits prove obstinate, a blistering-plaster may be put betwixt
the shoulders. The same method is to be followed when epileptic
fits precede the eruption of the small-pox, or measles, &c.

WHEN the disease is hereditary, or proceeds
from a wrong formation of the brain, a cure is not to be expected.
When it is owing to a debility, or too great an irritability
of the nervous system, such medicines as tend to brace and strengthen
the nerves may be used, as the Peruvian bark, and steel; or
the anti-epileptic electuaries, recommended by Fuller
and Mead. See Appendix, Electuary for the Epilepsy

THE flowers of zinc have of late been highly
extolled for the cure of the epilepsy. Though this medicine will
not be found to answer the expectations which have been raised
concerning it, yet in obstinate epileptic cases it deserves a
trial. The dose is from one to three or four grains, which may
be taken either in pills, or a bolus, as the patient inclines.
The best method is to begin with a single grain four or five
times a-day, and gradually to increase the dose as far as the
patient can bear it. I have known this medicine, when duly persisted
in, prove beneficial.

MUSK has sometimes been found to succeed in
the epilepsy. Ten or twelve grains of it with the same quantity
of factious cinnabar, may be made up into a bolus, and taken
every night and morning.

SOMETIMES the epilepsy has been cured by electricity.

CONVULSION FITS proceed from the same causes,
and must be treated in the same manner as the epilepsy.

THERE is one particular species of convulsion
fits which commonly goes by the name of St. Vitus's dance, wherein
the patient is agitated with strange motions and gesticulations,
which by the common people are generally believed to be the effects
of witchcraft. This disease may be cured by repeated bleedings
and purges; and afterwards using the medicines prescribed above
for the epilepsy, viz. the Peruvian bark, and snake-root, &c.
Chalybeate-waters are found to be beneficial in this case. The
cold bath is likewise of singular service, and ought never to
be neglected when the patient can bear it.

OF THE HICCUP.

THE hiccup is a spasmodic or convulsive affection
of the stomach and midriff, arising from any cause that irritates
their nervous fibres.

IT may proceed from excess in eating or drinking;
from a hurt of the stomach; poisons; inflammations or scirrhous
tumours of the stomach, intestines, bladder, midriff, or the
rest of the viscera. In gangrenes, acute and malignant
fevers, a hiccup is often the forerunner of death.

WHEN the hiccup proceeds from the use of aliment
that is flatulent, or hard of digestion, a draught of generous
wine, or a dram of any spirituous liquor, will generally remove
it. If poison be the cause, plenty of milk and oil must be drank,
as has been formerly recommended. When it proceeds from an inflammation
of the stomach, &c. it is very dangerous. In this case the
cooling regimen ought to be strictly observed, The patient must
be bled, and take frequently a few drops of the sweet spirits
of nitre in a cup of wine-whey. His stomach should likewise be
fomented with cloths dipped in warm water; or have bladders filled
with warm milk and water applied to it.

WHEN the hiccup proceeds from a gangrene or
mortification, the Peruvian bark, with other antiseptics, are
the only medicines which have a chance to succeed. When it is
a primary disease, and proceeds from a foul stomach, loaded either
with a pituitous or a bilious humour, a gentle vomit and purge,
if the patient be able to bear them, will be of service. If it
arises from flatulencies, the carminative medicines, directed
for the heart-burn, must be used.

WHEN the hiccup proves very obstinate, recourse
must be had to the most powerful aromatic and antispasmodic medicines.
The principal of these is musk; fifteen or twenty grains of which
may be made into a bolus, and repeated occasionally. Opiates
are likewise of service, but they must be used with caution.
A bit of sugar dipped in compound spirits of lavender, or the
volatile aromatic tincture, may be taken frequently. External
applications are sometimes also beneficial; as the stomach plaster,
or a cataplasm of the Venice treacle of the Edinburgh or London
dispensatory, applied to the region of the stomach.

I LATELY attended a patient who had almost
a constant hiccup for above nine weeks. It was frequently stopped
by the use of musk, opium, wine, and other cordial and antispasmodic
medicines, but always returned. Nothing however gave the patient
so much ease as brisk small beer. By drinking freely of this,
the hiccup was often kept off for several days, which was more
than could be done by the most powerful medicines. The patient
was at length seized with a vomiting of blood, which soon put
an end to his life. Upon opening the body, a large scirrhous
tumour was found near the pylorus or right orifice of the stomach.

CRAMP OF THE STOMACH.

THIS disease often seizes people suddenly,
is very dangerous, and requires immediate assistance. It is most
incident to persons in the decline of life, especially the nervous,
gouty, hysteric, and hypochondriac.

IF the patient has any inclination to vomit,
he ought to take some draughts of warm water, or weak camomile-tea,
to cleanse his stomach. After this, if he has been costive, a
laxative clyster may be given. He ought then to take laudanum.
The best way of administering it is in a clyster. Sixty or seventy
drops of liquid laudanum may be given in a clyster of warm water.
This is much more certain than laudanum given by the mouth, which
is often vomited, and in some cases increases the pain and spasms
in the stomach.

IF the pain and cramps return with great violence,
after the effects of the anodyne clyster are over, another, with
an equal or a larger quantity of opium, may be given; and every
four or five hours a bolus, with ten or twelve grains of musk,
and half a drachm of the Venice treacle.

IN the mean time, the stomach ought to be
fomented with cloths dipped in warm water, or bladders filled
with warm milk and water, should be constantly applied to it.
I have often seen these produce the most happy effects. The anodyne
balsam may also be rubbed on the part affected; and an anti-hysteric
plaster worn upon it, for some time after the cramps are removed,
to prevent their return.

IN very violent and lasting pains of the stomach,
some blood ought to be let, unless the weakness of the patient
forbids it. When the pain or cramps proceed from a suppression
of the menses, bleeding is of use. If they be owing to the gout,
recourse must be had to spirits, or some of the warm cordial
waters. Blistering-plasters ought likewise, in this case, to
be applied to the ancles. I have often seen violent cramps and
pains of the stomach removed by covering it with a large plaster
of Venice treacle.

OF THE NIGHT-MARE.

IN this disease the patient, in time of sleep,
imagines he feels an uncommon oppression of weight about his
breast or stomach, which he can by no means shake off. He groans,
and sometimes cries out, though he oftener attempts to speak
in vain. Sometimes he imagines himself encgaged with an enemy,
and in danger of being killed, attempts to run away, but finds
he cannot. Sometimes he fancies himself in a house that is on
fire, or that he is in danger of being drowned in a river. He
often thinks he is falling over a precipice, and the dread of
being dashed to pieces suddenly awakes him.

THIS disorder has been supposed to proceed
from too much blood; from a stagnation of blood in the brain
and lungs; &c. But it is rather a nervous affection, and
arises chiefly from indigestion. Hence we find that persons of
weak nerves, who lead a sedentary life, and live full, are most
commonly afflicted with the night-mare. Nothing tends more to
produce it than heavy suppers, especially when ate late, or the
patient goes to bed soon after. Wind is likewise a very frequent
cause of this disease; for which reason those who are afflicted
with it ought to avoid all flatulent food. Deep thought, anxiety,
or any thing that oppresses the mind, ought also to be avoided.

AS persons afflicted with the night-mare generally
moan, or make some noise in the fit, they should be waked, or
spoken to by such as hear them, as the uneasiness generally goes
off as soon as the patient is awake. Dr. Whytt says, he generally
found a dram of brandy taken at bed-time, prevent this disease.
That, however, is a bad custom, and, in time, loses its effect.
We would rather have the patient depend upon the use of food
of easy digestion, cheerfulness, exercise through the day, and
a light supper taken early, than to accustom himself to drams.
A glass of peppermint-water will often promote digestion as much
as a glass of brandy, and is much safer. After a person of weak
digestion, however, has ate flatulent food, a dram may be necessary;
in this case we would recommend it as the most proper medicine.

PERSONS who are young, and full of blood,
if troubled with the night-mare, ought to take a purge frequently,
and use a spare diet.

OF SWOONINGS.

PEOPLE of weak nerves or delicate constitutions
are liable to swoonings or fainting fits. These indeed are seldom
dangerous when duly attended to; but when wholly neglected, or
improperly treated, they often prove hurtful, and sometimes fatal.

THE general causes of swoonings are sudden
transitions from cold to heat; breathing air that is deprived
of its proper spring or elasticity; great fatigue; excessive
weakness; loss of blood; long fasting; fear, grief, and other
violent passions, or affections of the mind.

IT is well known, that persons who have been
long exposed to cold, often faint or fall into a swoon, upon
coming into the house, especially if they drink hot liquor, or
sit near a large fire. This might easily be prevented by people
taking care not to go into a warm room immediately after they
have been exposed to the cold air, to approach the fire gradually,
and not to eat or drink any thing hot, till the body has been
gradually brought into a warm temperature.

WHEN any one, in consequence of neglecting
these precautions, falls into a swoon, he ought immediately to
be removed to a cooler apartment, to have ligatures applied above
his knees and elbows, and to have his hands and face sprinkled
with vinegar or cold water. He should likewise be made to smell
to vinegar, and should have a spoonful or two of water, if he
can swallow, with about a third part of vinegar mixed with it,
poured into his mouth. If these should not remove the complaint,
it will be necessary to bleed the patient, and afterwards to
give him a clyster.

AS air that is breathed frequently, loses
its elasticity or spring, it is no wonder if persons who respire
in it often fall into a swoon or fainting fit. They are, in this
case, deprived of the very principle of life. Hence it is that
fainting fits are so frequent in all crowded assemblies, especially
in hot seasons. Such fits however must be considered as a kind
of temporary death; and to the weak and delicate, they sometimes
prove fatal. They ought therefore with the utmost care to be
guarded against. The method of doing this is obvious. Let assembly
rooms, and all other places of public resort, be large and well
ventilated; and let the weak and delicate avoid such places,
particularly in warm seasons.

A PERSON who faints, in such a situation,
ought immediately to be carried into the open air; his temples
should be rubbed with strong vinegar or brandy, and volatile
spirits or salts held to his nose. He should be laid upon his
back with his head low, and have a little wine, or some other
cordial, as soon as he is able to swallow it, poured into his
mouth. If the person has been subject to hysteric fits, castor
or asafoetida should be applied to the nose, or burnt feathers,
horn, or leather, &c.

WHEN fainting fits proceed from mere weakness
or exhaustion, which is often the case after great fatigue, long
fasting, loss of blood, or the like, the patient must be supported
with generous cordials. as jellies, wines, spirituous liquors,
&c. These however must be given at first in very small quantities,
and increased gradually as the patient is able to bear them.
He ought to be allowed to lie quite still and easy upon his back,
with his head low, and should have fresh air admitted into his
chamber. His food should consist of nourishing broths, sago-gruel
with wine, new milk, and other things of a light and cordial
nature. These things are to be given out of the fit. All that
can be done in the fit is to let him smell to a bottle of Hungary-water,
eau de luce, or spirits of hartshorn, and to rub his temples
with warm brandy, or to lay a compress dipped in it to the pit
of the stomach.

IN fainting fits that proceed from fear, grief,
or other violent passions or affections of the mind, the patient
must be very cautiously managed. He should be suffered to remain
at rest, and only made to smell to some vinegar. After he is
come to himself he may drink freely of warm lemonade, or balm
tea, with some orange or lemon-peel in it. It will likewise be
proper, if the fainting fits have been long and severe, to clean
the bowels by throwing in an emollient clyster.

IT is common in fainting fits, from whatever
cause they proceed, to bleed the patient. This practice may be
very proper in strong persons of a full habit; but in those who
are weak and delicate, or subject to nervous disorders, it is
dangerous. The proper method with such people is to expose them
to the free air, and to use cordial and stimulating medicines,
as volatile salts, Hungary-water, spirits of lavender, tincture
of castor, and the like.

OF FLATULENCIES, OR WIND.

ALL nervous patients, without exception, are
afflicted with wind or flatulencies in the stomach and bowels,
which arise chiefly from the want of tone or vigour in these
organs. Crude flatulent aliment, as green peas, beans, coleworts,
cabbages, and such like, may increase this complaint; but strong
and healthy people are seldom troubled with wind, unless they
either overload their stomachs, or drink liquors that are in
a fermenting state, and consequently full of elastic air. While
therefore the matter of flatulence proceeds from our aliments,
the cause which makes air separate from them in such quantity
as to occasion complaints, is almost always a fault of the bowels
themselves, which are too weak either to prevent the product
of elastic air, or to expel it after it is produced.

TO relieve this complaint, medicines ought
to be used as have a tendency to expel wind, and by strengthening
the alimentary canal to prevent its being produced there. Many
nervous people find great benefit from eating a dry biscuit,
especially when the stomach is empty. I look upon this as one
of the best carminative medicines; and would recommend it in
all complaints of the stomach, arising from flatulence, indigestion,
&c.

THE list of medicines for expelling wind
is very numerous; they often however disappoint the expectations
of both the physician and his patient. The most celebrated among
the class of carminatives are juniper berries; the roots of ginger
and zedoary; the seeds of anise, caraway, and coriander; gum
asafoetida and opium; the warm waters, tinctures, and spirits,
as the aromatic water, the tincture of woodfoot, the volatile
aromatic spirit, aether, &c.

DR. WHYTT says, he found no medicines more
efficacious in expelling wind than aether and laudanum. He generally
gave the laudanum in a mixture with peppermint-water and tincture
of castor, or sweet spirits of nitre. Sometimes, in place of
this, he gave opium in pills with asafoetida. He observes that
the good effects of opiates are equally conspicuous, whether
the flatulence be contained in the stomach or intestines; whereas
these warm medicines, commonly called carminatives, do
not often give immediate relief, except when the wind is in the
stomach.

WITH regard to aether, the Doctor says, he
has often seen very good effiects from it in flatulent complaints,
where other medicines failed. The dose is a tea-spoonful mixed
with two table-spoonfuls of water. Though the patient may begin
with this quantity, it will be necessary to increase the dose
gradually as the stomach can bear it. Aether is now given in
considerable greater doses than it was in Dr. Whytt's time. In
gouty cases he observes that aether, a glass of French brandy,
or of the aromatic water; or ginger, either taken in substance
or infused in boiling water, are among the best medicines for
expelling wind.

WHEN the care of flatulent patients is such
as makes it improper to give them warm medicines inwardly, the
Doctor recommends external applications, which are sometimes
of advantage. Equal parts of the anti-hysteric and stomach plaster
may be spread upon a piece of soft leather, of such size as to
cover the greatest part of the belly. This should be kept on
for a considerable time, provided the patient be able to bear
it; if it should give great uneasiness, it may be taken off,
and the following liniment used in its stead.

TAKE of Bates's anodyne balsam an ounce; of
the expressed oil of mace half an ounce; oil of mint two drachms.
Let these ingredients be mixed together, and about a table-spoonful
well rubbed on the parts at bed-time.

FOR strengthening the stomach and bowels,
and consequently for lessening the production of flatulence,
the Doctor recommends the Peruvian bark, bitters, chalybeates,
and exercise. In flatulent cases, he thinks some nutmeg or ginger
should be added to the tincture of the bark and bitters, and
that the aromatic powder should be joined with the filings of
iron.

WHEN windy complaints are attended with costiveness,
which is often the case, few things will be found to answer better
than four or five of the following pills taken every night at
bed-time.

TAKE of asafoetida two drachms; succotrine
aloes, salt of iron, and powdered ginger, of each one drachm;
as much of the elixir proprietatis as will be sufficient
to form them into pills.

ON the other hand, when the body is too open,
twelve or fifteen grains of rhubarb, with half a drachm or two
scruples of the Japonic confection, given every other evening,
will have very good effects.

IN those flatulent complaints which come on
about the time the menses cease, repeated small bleedings
often give more relief than any other remedy.

WITH regard to diet, the Doctor observes,
that tea, and likewise all flatulent aliments, are to be avoided;
and that for drink, water with a little brandy or rum is not
only preferable to malt liquor, but, in most cases, also to wine.

AS Dr. Whytt has paid great attention to this
subject, and as his sentiments upon it in a great measure agree
with mine, I have taken the liberty to adopt them; and should
only add to his observations, that exercise is in my opinion,
superior to all medicine, both for preventing the production
and likewise for expelling of flatulencies. These effects, however,
are not to be expected from sauntering about or lolling in a
carriage, but from labour, or such active amusements as give
exercise to every part of the body.

OF LOW SPIRITS.

ALL who have weak nerves are subject to low
spirits in a greater or less degree. Generous diet, the cold
bath, exercise and amusements, are the most likely means to remove
this complaint. It is greatly increased by solitude and indulging
gloomy ideas; but may often be relieved by cheerful company and
sprightly amusements.

WHEN low spirits are owing to a weak relaxed
state of the stomach and bowels, an infusion of the Peruvian
bark with cinnamon or nutmeg will be proper. Steel joined with
aromatics may likewise in this case be used with advantage; but
riding, and a proper diet, are most to be depended on.

WHEN they arise from a foulness of the stomach
and intestines, or obstruction in the hypochondriac viscera,
aloetic purges will be proper. I have sometimes known the Harrowgate
sulphur-water of service in this case.

WHEN low spiritsproceed from a suppression
of the menstrual or of the hemorrhoidal flux, these evacuations
may either be restored, or some others substituted in their place,
as issues, setons, or the like. Dr. Whytt observes, that nothing
has such sudden good effects in this case as bleeding.

WHENlow spirits have been brought
on by long continued grief, anxiety, or other distress of mind,
agreeable company, variety of amusements, and change of place,
especially travelling into foreign countries, will afford the
most certain relief.

PERSONS afflicted with low spirits should
avoid all kind of excess, especially of venery and strong liquors.
The moderate use of wine and other strong liquors is by no means
hurtful; but when taken to excess they weaken the stomach, vitiate
the humours,and depress the spirits. This caution is
the more necessary, as the unfortunate and melancholy often fly
to strong liquors for relief, by which means they never fail
to precipitate their own destruction.

OF HYSTERIC AFFECTIONS.

THESE likewise belong to the numerous tribe
of nervous diseases, which may be justly reckoned the reproach
of medicine. Women of a delicate habit, whose stomach and intestines
are relaxed, and whose nervous system is extremely sensible,
are most subject to hysteric complaints. In such persons a hysteric
fit, as it is called, may be brought on by an irritation of the
nerves of the stomach or intestines, by wind, acrid humour, or
the like. A sudden suppression of the menses often gives rise
to hysteric fits. They may likewise be excited by violent passions
or affections of the mind, as fear, grief, anger, or great disappointments.

SOMETIMES the hysteric fit resembles a swoon
or fainting fit, during which the patient lies as in a sleep,
only the breathing is so low as scarce to be perceived. At other
times the patient is affected with catchings and strong convulsions.
The symptoms which precede hysterical fits are likewise various
in different persons. Sometimes the fits come on with coldness
of the extremities, yawning and stretching, lowness of spirits,
oppression and anxiety. At other times the approach of the fit
is foretold by a feeling, as if there were a ball at the lower
part of the belly, which gradually rises towards the stomach,
where it occasions inflation, sickness, and sometimes vomiting;
afterwards it rises into the gullet, and occasions a degree of
suffocation, to which quick breathing, palpitation of the heart,
giddiness of the head, dimness of the sight, loss of hearing,
with convulsive motions of the extremities and other parts of
the body, succeed. The hysteric paroxysm is often introduced
by an immoderate fit of laughter, and sometimes it goes off by
crying. Indeed there is notmuch difference between the
laughing and crying of an highly hysteric lady.

OUR aim in the treatment of this disease
must be to shorten the fit or paroxysm when present, and to prevent
its return. The longer the fits continue, and the more frequently
they return, the disease becomes the more obstinate. Their strength
is increased by habit, and they induce so great a relaxation
of the system, that it is with difficulty removed.

IT is customary, during the hysteric fit or
paroxysm, to bleed the patient. In strong persons of a plethoric
habit, and where the pulse is full, this may be proper, but in
weak and delicate constitutions, or where the disease has been
of long standing, or arises from inanimation, it is not safe.
The best course in such cases is to rouse the patient by strong
smells, as burnt feathers, asafoetida, or spirits of hartshorn,
held to the nose. Hot bricks may also be applied to the soles
of the feet, and the legs, arms, and belly may be strongly rubbed
with a warm cloth. But the best application is to put the feet
and legs into warm water. This is peculiarly proper when the
fits precede the flow of the menses. In case of costiveness,
a laxative clyster with asafoetidawill be proper and,
as soon as the patient can swallow, two table-spoonfuls of a
solution of asafoetida, or of some cordial julep, may be given.

THE radical cure of this disorder will be
best attempted at a time when the patient is most free from the
fits. It will be greatly promoted by a proper attention to diet.
A milk and vegetable diet, when duly persisted in, will often
perform a cure. If, however, the patient has been accustomed
to a more generous diet, it will not be safe to leave it off
all at once, but by degrees. The most proper drink is water with
a small quantity of spirits. A cool dry air is the best. Cold
bathing and every thing that braces the nerves, and invigorates
the system, is beneficial; but lying too long in bed, or whatever
relaxes the body is hurtful. It is of the greatest importance
to have the mind kept constantly easy and cheerful, and, if possible,
to have it always engaged in some agreeable and interesting pursuit.

WHEN hysteric fits are occasioned by sympathy,
they may be cured by exciting an opposite passion. This is said
to have been the case of a whole school of young ladies in Holland,
who were all cured by being told, that the first who was seized
should be burnt to death. But this method of cure, to my knowledge,
will not always succeed. I would therefore advise, that young
ladies who are subject to hysteric fits should not be sent to
boarding schools, as the disease may be caught by imitation,

THE proper medicines are those which strengthen
the alimentary canal and the whole nervous system, as the preparations
of iron, the Peruvian bark, and other bitters. Twenty drops of
the elixir of vitriol, in a cup of the infusion of the bark,
may be taken twice or thrice a-day. The bark and iron may likewise
be taken in substance, provided the stomach can bear them; but
they are generally given in too small doses to have any effect.
The chalybeate waters generally prove beneficial in this disorder.

IF the stomach is loaded with phlegm, vomits
will be of use; but they should not be too strong, nor frequently
repeated, as they tend to relax and weakenthe stomach.
If there be a tendency to costiveness, it must be removed either
by diet, or by taking an opening pill as often as it shall be
found necessary.

TO lessen the irritability of the system,
antispasmodic medicines will be of use. The best antispasmodic
medicines are musk, opium, and castor. When opium disagrees with
the stomach, it may either be applied externally, or given in
clysters. It is often successful in removing those periodical
head-achs to which hysteric andhypochondriac patients
are subject. Castor has in some cases been found to procure sleep
where opium failed; for which reason Dr. Whyttadvises,
that they should be joined together. He likewise recommends the
anti-hysteric plaster to be applied to the abdomen. Though
antispasmodics and anodynes are universally recommended in this
disease, yet all the extraordinary cures that I ever knew in
hysteric cases were performed by means of tonic and corroborating
medicines.

HYSTERIC women are often afflicted with cramps
in various parts of the body, which are most apt to seize them
in bed, or when asleep. The most efficacious medicines in this
case are opium, blistering-plasters, and warm bathing or fomentations.
When the cramp or spasm is very violent, opium is the remedy
most to be depended on. In milder cases, immersing the feet and
legs in warm water, or applying a blistering-plaster to the part
affected, will often be sufficient to remove the complaint. In
patients whose nerves are uncommonly delicate and sensible, it
will be better to omit the blistering-plaster, and to attempt
the cure by opiates, musk, camphire, and the warm bath.

CRAMPS are often prevented or cured by compression.
Thus cramps in the legs are prevented, and sometimes removed,
by tight bandages, and, when convulsions arise from a flatulent
distention, of the intestines, or from spasms beginning in them,
they may be often lessened or cured by making a pretty strong
compression upon the abdomen by means of a broad belt. A roll
of brimstone held in the hand is frequently used as a remedy
for cramps: Though this seems to owe its effect chiefly to imagination;
yet, as it sometimes succeeds, it merits a trial. When spasms
or convulsive motions arise from sharp humours in the stomach
and intestines, no lasting relief can be procured till these
are either corrected or expelled. The Peruvian bark has sometimes
cured periodic convulsions after other medicines had failed.
Some persons afflicted with cramps pretend to reap great benefit
from small bundles of rosemary tied all night about their feet,
ancles, and knees.

OF HYPOCHONDRIAC AFFECTIONS.

THIS disease generally attacks the indolent,
the luxurious, the unfortunate, and the studious. It becomes
daily more common in this country, owing no doubt to the increase
of luxury and sedentary employments. It has so near a resemblance
to the immediately preceding, that many authors consider them
as the same disease, and treat them accordingly. They require
however a very different regimen; and the symptoms of the latter,
though less violent, are more permanent than those of the former.

MEN of a melancholy temperament, whose mindsare capable of great attention, and whose passions are not
easily moved, are, in the advanced periods of life, most liable
to this disease. It is usually brought on by long and serious
attention to abstruse subjects, grief, the suppression of customary
evacuations, excess of venery, the repulsion of cutaneous eruptions,
long continued evacuations, obstructions in some of the viscera,
as the liver, spleen, &c.

HYPOCHONDRIAC persons ought never to fast
long, and their food should be solid and nourishing. All acescent,
and windy vegetables are to be avoided. Flesh meats agree best
with them, and their drink should be old claret, or good madeira.
Should these disagree with the stomach, water with a little brandy
or rum in it may be drank.

CHEERFULNESS and serenity of mind are by all
means to be cultivated. Exercise of every kind is useful. The
cold bath is likewise beneficial; and where it does not agree
with the patient, frictions with the flesh-brufh or a coarse
cloth may be tried. If the patient has it in his power, he ought
to travel either by sea or land. A voyage or a long journey,
especially towards a warmer climate will be of more service than
any medicine.

THE general intentions of cure, in this disease,
are to strengthen the alimentary canal, and to promote the secretions.
These intentions will be best answered by the different preparations
of iron and the Peruvian bark, which, after proper evacuations,
may be taken in the same manner as directed in the preceding
disease.

IF the patient be costive, it will be necessary
to make use of some gentle opening medicine, as pills composed
of equal parts of aloes, rhubarb, and asafoetida, with as much
of the elixir proprietatis, as is necessary to form the ingredients
into pills, Two, three, or four of these may be taken as often
as it shall be found needful to keep the body gently open. Such
as cannot bear the asafoetida may substitute Spanish soap in
its place.

THOUGH a cheerful glass may have good effects
in this disease, yet all manner of excess is hurtful. Intense
study, and every thing that depresses the spirits, are likewise
pernicious.

THOUGH the general symptoms and treatment
of nervous disorders were pointed out in the beginning of this
chapter; yet, for the behoof of the unhappy persons afflicted
with those obstinate and complicated maladies, I have treated
several of their capital symptoms under distinct or separate
heads. These however are not to be considered as different diseases,
but as various modifications of the same disease.They all arise
from the same general causes, and require nearly the same method
oftreatment. There are many other symptoms that merit
particular attention, which the nature of my plan will not permit
me to treat of at full length. I shall therefore omit them altogether,
and conclude this chapter with a few general remarks on the most
obvious means of preventing or avoiding nervous disorders.

IN all persons afflicted with nervous disorders,
there is a great delicacy and sensibility of the whole nervous
system, and an uncommon degree of weakness of the organs of digestion.
These may be either natural or acquired. When owing to a defect
in the constitution, they are hardly to be removed; but may be
mitigated by proper care. When induced by diseases, as long or
repeated fevers, profuse haemorrhages, or the like, they prove
also very obstinate, and will yield only to a course of regimen
calculated to restore and invigorate the habit.

BUT nervous affections arise more frequently
from causes which it is in a great measure in our own power to
avoid, than from diseases, or an original fault in the constitution.
Excessive grief, intense study, improper diet, and neglect of
exercise, are the great sources of this extensive class of diseases.

IT has been already been observed, that grief
indulged destroys the appetite and digestion, depresses the spirits,
and induces an universal relaxation and debility of the whole
system. Instances of this are daily to be seen. The loss of a
near relation, or any other misfortune in life, is often sufficient
to occasion the most complicated series of nervous symptoms.
Such misfortunes indeed are not to be avoided, but surely their
effects, by a vigorous and proper exertion of the mind, might
be rendered less hurtful. For directions in this matter we must
refer the reader to the article GRIEF, in the Chapter on the
passions.

THE effects of intense study are pretty similar
to those occasioned by grief. It preys upon the animal spirits,
and destroys the appetite and digestion. To prevent these effects,
studious persons ought, according to the Poet, to toy with
their books. They should never study too long at a time;
nor attend long to one particular subject, especially if it be
of a serious nature. They ought likewise to be attentive to their
posture, and should take care frequently to unbend their minds
by music, diversions, or going into agreeable company.

WITH regard to diet, I shall only observe,
that nervous diseases may be induced either by excess or inanition.
Both of these extremes hurt digestion, and vitiate the humours.
When Nature is oppressedwith fresh loads of food, before
she has had time to digest and assimilate the former meal, her
powers are weakened, and the vessels are filled with crude humours.
On the other hand, when the food is not sufficiently nourishing,
or is taken too seldom, the bowels are inflated with wind, and
the humours, for want of regular fresh supplies of wholesome
chyle, are vitiated. These extremes are therefore with equal
care to be avoided. They both tend to induce a relaxation and
debility of the nervous system, with all its dreadful train of
consequences.

BUT the most general cause of nervous disorders
is indolence. The active and laborious are seldom troubled
with them. They are reserved for the children of ease and affluence,
who generally feel their keenest force. All we shall say to such
persons is, that the means of prevention and cure are both in
their own power. If the constitution of human nature be such,
that man must either labour or suffer diseases, surely no individual
has any right to expect an exemption from the general rule.

THOSE, however, who are willing to take exercise,
but whose occupations confine them to the house, and perhaps
to an unfavourable posture, really deserve our pity, We have
in a former part of the book endeavoured to lay down rules for
their conduct; and shall only add, that where these cannot be
complied with, their place may, in some measure, be supplied
by the use of bracing and strengthening medicines, as the Peruvian
bark, with other bitters; the preparations of steel; the elixir
of vitriol, &c.